Mind & Body
Give Nighttime Leg Pain a Swift Kick
8/3/2017 11:51:15 AM

Pain or discomfort in the legs at night can be uncomfortable, disrupting sleep and causing anxiety. Two of the conditions that can cause these symptoms are restless leg syndrome (RLS) and nocturnal leg cramps. Although they both cause discomfort in the legs at night, pinpointing which one is occurring can help the patient find relief and much needed rest. 

With RLS, it often feels as though something is crawling on the legs. Many sufferers experience an uncontrollable urge to move their legs. It occurs at night, making it difficult to relax and sleep. The next morning, their legs ache and they remain exhausted. 

RLS affects seven to ten percent of the U.S. population. It afflicts both genders but women are more likely to have it than men. Although it can begin at any age, adults in their 50s and 60s report it the most.

"Most patients describe it as aching, crawling, creeping, or throbbing sensations,” explains Phillip Conner, MD, board certified sleep specialist and medical director of the Sleep Disorder Center of Louisiana. "They have an uncomfortable need to move their legs. Sometimes they find relief moving them in bed while they lay down but other times, they have to get out of bed and walk around. The sensations are rarely felt in the arms and they usually are felt in both legs, but it can alternate sides in some patients.”

Diagnosing RLS is done by physician evaluation of these five basic criteria:
  • A strong and often overwhelming urge to move the legs.
  • This urge is often worse during rest or inactivity.
  • While moving the legs, relief is found and the urge to move or the crawling sensation goes away.
  • The sensations are worse in the evening or night.
  • The above four features are not due to any other medical or behavioral condition. 
  • He says one of the classic features of RLS is that the symptoms can be worse at night with a distinct symptom-free period in the early morning. "This allows the patient to finally rest and fall asleep, allowing their body to refresh itself even in a small measure,” says Dr. Conner.
  • "In most cases, RLS symptoms occur occasionally. In moderate to severe cases, the patient experiences symptoms several times a week, resulting in significant disruption of sleep causing difficulties with their daily tasks,” he says.

The cause of RLS is unknown, but researchers say there may be a link between low levels of the brain chemical dopamine and the symptoms of RLS. The medication to treat those with Parkinson’s disease can also bring relief to some people with RLS, although researchers say the two conditions don’t appear to be related. 

Leg cramping is a similar, but unrelated, nighttime leg discomfort, otherwise known as nocturnal leg cramps. They can last for a few seconds or for several minutes and are usually felt in the calf muscle, awaking the person from sleep. Soreness where the cramp occurred is usually felt the next morning. Men and women report nocturnal leg cramps equally and they occur more commonly in adults over the age of fifty.  

"Nocturnal leg cramps and RLS may seem to be the same condition because the patient experiences discomfort in their legs at night, but there are distinct differences between the two conditions. The main differences are that RLS does not cause pain or cramping; RLS causes the desire to move the legs, while nocturnal leg cramps often prevent movement, and movement often provides relief in RLS, while stretching provides relief with nocturnal leg camps,” Dr. Conner explains.

Relief for nocturnal leg cramps can often come from lifestyle changes, such as:
  • Taking a warm bath before bed to ease muscle tightness.
  • Stretching legs prior to bed.
  • Avoiding high-heeled shoes, for women.
  • If these remedies don’t provide relief, Dr. Conner suggests seeing a doctor as there could be a deficiency of magnesium, iron, or potassium that might be linked to muscle cramping. 
  • For RLS, there are medications available to relieve the symptoms. "At this time, there isn’t one single medication to effectively manage RLS for all patients. Depending on their individual symptoms, there are several medications available and we can tweak as needed,” Dr. Conner says. In some cases, people with RLS experience remissions, or periods of time when the symptoms decrease or disappear; although they usually return at some point. 
  • "Some people have mild RLS symptoms that do not significantly impact their sleep so they are able to live their lives without treatment,” says Dr. Conner. "When it begins to impact the body’s ability to rest and get refreshing sleep, it’s time to see a doctor for an evaluation. There are remedies and treatments available that can help the symptoms decrease significantly or that remove them completely. It’s always great to see patients be able to fully engage in their lives again.”

RLS and nocturnal leg cramps are two of the more than 80 sleep disorders treated at the Sleep Disorder Center. 

For more information about RLS or nocturnal leg cramps, call the Sleep Disorder Center of Louisiana at (337) 310-REST.
Posted by: Christine Fisher | Submit comment | Tell a friend

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